The head of the U.N.'s AIDS program says the stigma attached to HIV is actually fueling the epidemic worldwide. A new U.N. study says HIV-positive women, migrants and minorities usually face double discrimination. The study was released at the World Racism Conference in Durban.

Mercy Makhalemele was diagnosed with HIV eight years ago. "When I was diagnosed," she says, "I was working for a very big rattan company. I was dismissed from my work. Two days [later], my husband threw me out of the house. I was physically abused."

Not long after that, Ms. Makhalemele began the long process of educating and empowering herself. Today, she has become an AIDS rights activist, and she runs a community development and training center in Soweto.

She is working to make life better for HIV-positive people in South Africa. But the stigma and discrimination she faced when she first disclosed her HIV status has not yet disappeared.

According to U.N. AIDS chief Peter Piot, it is a global problem. He says he knows of no country in the world where people with HIV do not face some kind of stigma, discrimination or exclusion. And he says the virus "thrives on intolerance and xenophobia. ... Stigma and discrimination associated with HIV are among the main driving forces, if not the main driving force, behind this epidemic," he says.

Dr. Piot spoke at the start of a new study on the stigma associated with HIV and AIDS in India and Uganda.

The report says in Indian hospitals, HIV-positive patients receive worse medical care than their HIV negative counterparts. Dr. Shalini Bharat wrote the part of the study dealing with India. "Discrimination, however, does not end during an individual's lifetime," she says. "Selectively wrapping the dead body of [HIV]-positive patients in plastic sheets and denying the customary death rituals completes their stigmatization after death."

The report says the situation is worse for people who also belong to other marginalized groups, including women, migrants and minorities. Like Ms. Makhalemele, they often face multiple discrimination. They are discriminated against based on their HIV positive status, and also on their gender, ethnicity, profession, caste or socio-economic status.

The U.N. AIDS chief emphasizes the need to do something about the stigma, rather than just studying it. "Tackling the stigma and discrimination is central to the response to the epidemic," he says. "If we are ever going to be successful in stopping this epidemic and to ensure a good quality of life for those who have it, and are affected, we need an all-out effort against [the] stigma [and] discrimination associated with HIV."

Dr. Piot says there are concrete steps that can reduce the stigma. He urges governments to lead from the front, to break the silence surrounding HIV and AIDS. He calls upon religious leaders to take an active role in combating stigma.